claims processor I

PGBA • Columbia, SC

17d • Onsite

About The Position

Responsible for the accurate and timely processing of claims.

Requirements

• High School Diploma or equivalent
• Strong analytical, organizational and customer service skills.
• Strong oral and written communication skills.
• Proficient spelling, punctuation and grammar skills.
• Good judgment skills.
• Basic business math skills
• Basic office equipment.
• This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen.

Nice To Haves

• 1 year-of experience in a healthcare or insurance environment.
• Ability to use complex mathematical calculations.
• Proficient in word processing and spreadsheet applications.
• Proficient in database software.

Responsibilities

• Researches and processes claims according to business regulation, internal standards and processing guidelines.
• Verifies the coding of procedure and diagnosis codes.
• Resolves system edits, audits and claims errors through research and use of approved references and investigative sources.
• Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary.

Benefits

• Subsidized health plans, dental and vision coverage
• 401k retirement savings plan with company match
• Life Insurance
• Paid Time Off (PTO)
• On-site cafeterias and fitness centers in major locations
• Education Assistance
• Service Recognition
• National discounts to movies, theaters, zoos, theme parks and more

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED